A case of massive intestinal blood loss from multiple duodeno-jejunal diverticula is described. A 39-year-old man was referred to our hospital because of recurrent bloody stool and worsening anemia. Upper and lower endoscopy, selective abdominal angiography, and radionuclide scanning were performed to seek the cause of the intestinal bleeding, but none of these studies revealed the source of bleeding. Small-bowel barium follow-through examination showed numerous diverticula in the distal duodenum and proximal jejunum. Excision of the duodenal diverticulum and resection of the involved portion of the jejunum cured the patient. On histopathological examination, an ulcerative lesion with an exposed vessel suggestive of the source of bleeding was seen in the resected duodenal diverticulum. Although duodeno-jejunal diverticula are rare, the importance of a careful search for this malformation in a patient with intestinal blood loss is stressed.

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BackgroundThe present case study investigated the feasibility of using manga (Japanese-style comic books) to promote physical activity and healthy eating behavior in Japanese patients with metabolic syndrome.MethodsA one-arm pre-post intervention was conducted in a Japanese suburban community. Twenty participants with a diagnosis of metabolic syndrome were recruited via health checkups. Health promotion manga were developed by the researcher, a publishing specialist, and a professional illustrator. We measured participants’ self-reported physical activity, eating behavior, and psychological readiness to change toward engaging in healthy behavior.ResultsAt 1 month after the intervention there were no significant differences in physical activity scores, but small positive changes in vigorous (R2 = 0.02) and moderate (R2 = 0.01) physical activity scores were observed. Total healthy eating behavior scores were significantly improved (p < 0.05, R2 = 0.47). In addition, participants reported positive change in psychological readiness, such as increased intention to engage in healthy behavior, enhanced self-efficacy, and benefits of using manga.ConclusionsThis study demonstrates that manga interventions have potential to encourage healthy eating in patients with metabolic syndrome.Electronic supplementary materialThe online version of this article (10.1186/s13690-018-0273-5) contains supplementary material, which is available to authorized users.

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Objective:To examine whether the incidence of health problems increases during the COVID-19 pandemic.Methods:Using the health examination data (April 2018-March 2021) of Japanese workers aged 15 to 64 years, the 1-year incidence of five health problems (overweight, hypertension, hypercholesterolemia, hyperglycemia, and liver damage) and four unhealthy habits (snacking, heavy drinking, physical inactivity, and sleep deprivation) were compared before and during the COVID-19 pandemic.Results:The 1-year incidence of overweight, hypertension, hyperglycemia, and liver damage increased by 15% to 65% during the COVID-19 pandemic. Increased weight gain, related to decrease physical activity during the COVID-19 pandemic, was significantly associated with increased incidence of health problems.Conclusions:The COVID-19 pandemic have deteriorated workers’ health even without the COVID-19 infection. Lifestyle interventions should be promptly started particularly targeting workers with gained weight to avoid more serious consequences.